| NPI | 1063779908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DC MD042450) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: VA 0101265043) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101265043) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2023-05-02 |